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Karunashraya: Death With Dignity

A single powerful thought can change the course of a life. Or many. Who would have imagined that 14,800 cancer patients would receive critical palliative care over 20 years only because in 1992, Kishore Rao, General Manager of Madura Coats, took early retirement to initiate the Karnataka Chapter of the Indian Cancer Society?

The momentous journey began when Rao volunteered his time to the Kidwai Memorial Institute of Oncology and witnessed the financial and emotional devastation suffered by cancer patients and their families.

This suffering, he believed, could be lessened with the help of an informed approach towards the disease, its treatment and the hopelessness it leaves in its wake.
An approach that would help a patient when medicine has ceased to help, hospitals are no longer an option, and a family knows not where to go for support.

Along with the thought that care should not stop when the hope for a cure fades came the vision for a hospice. A chance meeting with Dr S N Simha and synergy with Rotary Bengaluru, Indiranagar, led to the formation of the Bangalore Hospice Trust in 1994.

Initially, without any land or infrastructure, the trust only organised home care with the help of volunteers. But in May 1999, across five acres leased from the government of Karnataka, Karunashraya, the first facility in India of its kind, opened its doors to terminally ill patients who wanted nothing more than to be treated with sensitivity and humanity in their last days.

This October, the trust completed two decades of providing free-of-charge professional palliative care to cancer patients beyond cure. A visit to Karunashraya is an experience unlike any other.

The serene stone building, considered one of the best architectural examples of a green sensibility (it harvests rain water, recharges water, and generates solar power), was designed by Chandavarkar and Thacker and is situated right in the middle of Old Airport–Varthur Main Road.

The building greets you with a series of green pockets, water bodies aglow with colourful fish, corridors awash in sunlight and a sense of calm. A volunteer has just arrived with a basket packed with hand-made soaps that she wants to donate. The Charity Shop where every single article has been donated to raise money for the hospice is busy catering to a sudden rush. Nurses are tending to patients in wards. An old woman, obviously unwell, sits in a verandah with her son and they gaze at the fish in the pond wordlessly. Food is being cooked in the kitchen for over 55 patients and members of the staff. Clothes are being washed in a mechanised laundry. A 100-seat auditorium is fully equipped to facilitate conferences and training. A multi-faith place of worship, an ornamental forest, a play area for children complete the picture.

Archana Ganesh, who left a corporate job to work here full-time, shows us around the kitchen, staff quarters, the wards. A morgue and a prayer hall stand near each other. These are meant for poor families who cannot immediately organise cremation and last rites for their loved ones. Despite the obvious signs that this is a place where life and death walk hand in hand, the air is not sombre.

Chief Executive Officer M L Suresh Babu smiles when you tell him that nothing in the building even remotely reeks of hopelessness and disease. He says, “Palliative care is a misunderstood term. What we do here begins when the curative aspect is exhausted. We provide psychological support through counselling to patients and their care-givers, and pain and symptom management till it is needed. We can’t ensure life but we can promise peace and dignity.”

That sense of dignity comes when patients are allowed to wear their home clothes, are not shut away from their families, and are allowed to meet loved ones without being restricted by visiting hours. They can walk to a recreation zone to watch TV, be a part of festive celebrations and even enjoy their favourite meals on demand.

Archana shows us a meals register where requests of all the patients are recorded three times a day and then cooked in the kitchen. She recalls, “We once had a young boy who wanted masala dosa every day. He wanted it to be red and crisp and it had to be bought.”

The hospice goes out of its way to bring families together and fulfil the wishes of its inmates, as they know, time is the only thing in short supply here. Not compassion. Or empathy.

Dealing with death frequently can take its toll on both the staff and the families caring for their loved ones and Karunashraya offers them what it calls, ‘diversion therapy’ where volunteers come and play music and engage the inmates to refresh their senses.

Says Archana, “We have all learnt to let go here and to come to terms with death. The need for a place like this is evident from the fact that Bengaluru is now considered the cancer capital of India and studies indicate it is because of strees, change in lifestyle and genetics.”

The demand for a bed in Karunshraya is so high that every day three to four patients are turned away and that is why construction is afoot to accommodate 24 more beds.

“Our goal has been to help whoever we can regardless of their caste or status. We were able to do so with the help of donations by individuals and corporates but awareness about what we do is low and we need more help to expand more, help more.”

We are told, everything in the building right from the reception desk to the wheel chairs, was donated, and Karunashraya has come a long way from that point when there was no rice in the kitchen and a donor sent 50 bags immediately.

Karunashraya today needs volunteers, corporate funding and media support to continue its journey in a more expansive way. Archana says, “Someone once said, ‘why should we donate money to a place where people come to die?’ To that I say, every life is important and we should value it as much as and as long as we can.”

Reema Moudgil works for The New Indian Express, Bangalore, is the author of Perfect Eight, the editor of Chicken Soup for the Soul-Indian Women, an artist, a former RJ and a mother. She dreams of a cottage of her own that opens to a garden and where she can write more books, paint, listen to music and just be.

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